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Individual
MARK RICHARD HISKES
Active
Individual
MARK RICHARD HISKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000693
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100119070
—
IN
01
—
1033312020
DME
IN
Enumeration date
06/28/2005
Last updated
11/22/2011
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